Of calculi and the such

Have you ever had a calculus? If the answer is ‘yes’, my sympathies. If not, let me hope and pray that you never get one. If you did get one, let me pray that you never get another one. As for me, I had them twice, and while it was a torrid period, it did offer its lighter moments to me.

Arun my second son interjects, what Calculus? I tell him to be patient, don’t jump the gun.

I lived and worked in Bombay those days (early 80’s). We were driving to Nashik that particular day from Bombay (Bombay then was Bombay, not Mumbai and Nasik was Nasik, not Nashik) and it ended as a fairly good business trip. I got back, bone tired and brain rattled, the roads were bad in some parts and the music played in the car very loud. I was also feeling that a back pain was kicking in, a nagging pain on the lower back. I figured that it was due to the cramped seating & the longish drive.

Arun hearing the story, asks me why I never turned down the volume of the car stereo and I explain to him that it was actually a shared taxi that I used between Dadar – Nasik and back. So there are others in the car and me being the youngest of the lot, could not get my word of objection in..Arun is not able to understand the concept of a shared taxi. Fortunately for him & me, we see a nice ‘ready made food ad’ on an Indian TV channel just about then, where the taxi driver is calling for passengers and how he gets different types of people, the vendor & his basket, the hens….all that stuff & some 9 people into that taxi. Something like a mini bus. Now that he sees it on TV, he gets the point. He is all ears again.

It is sometimes fun to have a listener asking lots of questions, but you realize that as you grow old, it can be exasperating. You tend to lose the thread and you start to drift off, Arun is attentive though, he brings me back to focus, with the car trip and the calculus.

Yes, now I am back in Bombay, I get into the crowded suburban train – the dreaded Central railway services, and get off at Bhandup, where I lived those days with my brother & cousins, get into another of those shared services, this time an auto rickshaw (Arun’s eyes light up, he loves auto’s – he says the feel of the wind on his face, the sound etc excites him) for the one rupee ride home from the train station. I reach home, no problems so far, decide to pee and what do I see? Bloody pee…I was a bit shaken. Wondered what was wrong (No, Arun, there was no internet & google and the such to check out on the web in those days, listen to me, now don’t interrupt…). Waited out the evening. The pains started. Throbbing, pulsating, phew it was tough I tell you, and each time I peed, a bit of blood in the urine. The pain was horrible, coming & going in waves, it was nothing like I had ever experienced. Tears were streaming out of my eyes at that time, and I saw all kinds of stars and white lights. It was like I was seeing the Arora Borealis in the northern skies. I was trembling after some of those spasms, actually.

Arun interrupts, ‘what Arora Borealis’? I tell him to shut up & listen, promising to explain the Arora Borealis later.

I rushed out to meet my doctor friend, Dr Pawar, the next morning. He heard me out and felt that I had a kidney stone. He suggested that I get myself checked by an urologist. Off I went to Ghatkopar to meet Dr Patel whom he had recommended. By this time the pain was unbearable, coming and going in quick waves. The doc looks at me and says that I should get admitted to his hospital. He quickly injects me with a painkiller and tells me that X rays need to be taken, to start with. ‘Yes, OK, thank you doctor, I will do what you say’…off to the X ray lab where the procedure was completed without much ado. I get the film and go to the doctor to be told.. ‘Aha! there it is, I can see the calculus in the ureter and what you are going through now is intense renal colic’…

Well, well, I had studied calculus, I had some knowledge about that kind of mathematics though I was forgetting the details, but then what did calculus have to do with my ureter and a kidney stone? Dad was a doctor, still this was new to me, I had never heard of calculus in the urethra and you know how the doctors of those days were, they had no time or interest to explain these details. These overloaded guys brush you off when you pepper them with questions. I decided to keep quiet, just listen for now and ask my friend Dr Pawar later. Anyway calculus (pebble in greek) was what it was. I guessed that it was some sort of kidney stone rearing to come out of my body due to the gravitational force exerted by the earth.

Arun is giggling, you know how kids are, when you start talking about stuff that is generally not brought out into open conversation, like ureter, urethra and all that..he wanted to know what, where, I managed to shut him up & continued.

The pain was still there, I was groaning and was promptly ordered to bed by Dr Patel. It was a double room, there was another man in there, no idea what he was admitted in for. So, there I was, supine, wondering what next, when the nurse comes in. Right away, I knew we were from the same state in India..Kerala. Malayalis can usually pick out their brethren easily in a crowd. We have unique features, names, mannerisms and accent and as is well known, the nursing profession worldwide is dominated by these fantastic women from Kerala. Her name was Mariamma.

Now what? Mariyamma takes one look at the bedside chart and cluck clucks. ‘you have a kidney stone, is it painful?’ Phew… Chechi (sister) can you not see that I am half dead with pain? She now wonders how I managed this at this young age, muses that it could be due to my improper fluid intake or diet…busy life in Bombay & all….Mariyama then drops the bomb shell ‘The doc has advised an enema for you to reduce the pain, it will reduce pressure on the urinary bladder ’. I was aghast….an enema, what in hell!!!..and I did not really or exactly know what an enema is all about, though I had heard vague mentions of getting out stuff from your bowels in forceful ways using water pressure..

I squirmed, tried persuading Mariyamma that I had not eaten anything anyway , that I was OK and that I did not really need an enema, all of no avail, no way would she budge, she retorted wisely that I probably had lot of gas in there.. She then went to get the tools for the procedure and came back with that characteristic white enameled vessel and the rubber tube. Then she says ‘turn over to your side’. I was getting really embarrassed now, wondering if the unthinkable was about to happen. And she goes on, ‘now open up your legs’ (it is quite difficult to translate exactly what she said, but I hope you guys know what I mean). Even in that position, even with the extreme discomfort, even with the throbbing pain, I wondered about the irony of the situation. A lady, telling me, a man to open up??? Nevertheless, there was nothing I could do but shamefully obey. The other guy in the room could be seen sprouting a snigger, making the situation even worse.

Arun is giggling like hell by now hearing all this, he eggs me to go on…..he is getting impatient, I guess, to hear what happened.

Well, I got the idea and Mariamma, shoved the tube up. Holy cow, the next seconds were real hell, hot water coursing up. I was completely lost in all kinds of torrid feelings, discomfort, shame, and what not. Finally the act was done, she pulled out the tube, I was full of hot water and she says, OK, go and get it out. I ran in and virtually exploded..

Thus ended my one and only enema experience. I was shattered actually, wondering if I could ever look at Mariamma again. What a terrible experience!! Must say I felt better though, afterwards.

The next day, I was feeling better and the doc told me that the stone was neither big nor small, so it would eventually pass out when peeing, and that it was on its way down, albeit slowly, due to its size. He stated that I could go home, take some rest and asked me to be on the look out for the stone when delivered, as it was needed for analysis. My room-mates at home gleefully pulled my legs about the enema incident & Mariamma’s ‘open thy legs’ command, for many years after….

I went to Dr Pawar later in the day and he explained that in medical terms kidney stones are called Urinary Calculi. He suggested that I drank lots and lots of fluids to flush it out. With a wink, he added that I should probably start out by drinking a couple of bottles of beer and continue so till the stone came out. Now, Now, that was the saving grace, just what you needed to hear from a doctor…My room-mates of course offered to help, no way I was going to accommodate them after all their earlier taunts.

‘Kingfisher beer to the rescue’….I drank beer and read books for the next two days. Finally, and at long last, while peeing with dread, out came the stone in a blinding flash (you can imagine the pain) …about 4 mm long and 3 mm across. Oblong in shape, with jagged edges..the reason for the pain and the blood.

Arun pops up with an idea, don’t you think the beer companies can use this idea for advertisement? I shut him up again…

And that was how I delivered that inanimate object, christened ‘renal calculus’.

I did get a second one, many years after, this one was conceived in the middle of the gulf war, in Riyadh. It stayed on for a while, though the colicky part (labor pains) subsided quickly. It was eventually delivered at Fort Lauderdale in Spring 91, again after a few bottles of beer (Now, keep in mind that you do not get beer in Saudi) while there for a conference.

No more Calculus or Algebra…All is fine now, except for memories of Mariamma and the enema.

When I see Kingfisher beer, I still silently mutter thanks. Do you know why? Because if the calculus had not come out naturally, they would have pulled it out with a special pair of forceps equipped with a basket at its end, through you know where…No way will I go through that, nor do I want to listen to worse quips from Mariamma..

Authors notes:

This was actually written some 9 years back, but I found it recently in an old flash drive and decided to post it.

Some friends asked me why I did not opt for a Lithotripter treatment, a system where you are suspended in a basket in a water tub and sonic shock waves are directed at the calculus to smash it to powder, so that you eventually pee the residue off. A specialist doctor tells me that LT’s are used only for bigger stones, >5mm and <20mm in size..